• Eva Lesén, Lisa Ericson, Christian Simonsberg, Riitta Varelius, Ingela Björholt, and Bo Söderpalm.
• Nordic Health Economics AB, Gothenburg, Sweden.
• Pain Med. 2013 Sep 1;14(9):1374-80.

ObjectiveThe objective of this study was to investigate the dose pattern of low-dose buprenorphine patches among patients in Swedish clinical practice. The clinical experts among the coauthors interpreted the results in relation to possible indications of development of tolerance and/or dependence/addiction.Design And SettingThis was a nationwide, observational study using data from the Swedish Prescribed Drug Register.SubjectsIndividuals who were dispensed the low-dose buprenorphine patches continuously for more than 24 weeks during July 1, 2005 to February 28, 2011 were included.MethodsThe dose pattern was analyzed as the change in dose over time for each patient: 1) the dose at baseline compared with each of the following 8-week intervals, and 2) the dose at baseline compared with the dose during the patients' last treatment period.ResultsThe majority of the patients were female (74%), and most were 75 years and older (69%). The median treatment duration was 260 days, and 4% and 1% of patients remained on continuous treatment for 2 and 3 years, respectively. The mean dose was 11 μg/h at baseline, and 15 μg/h during the patients' last treatment period. The average dose increased by 4 μg/h during the patients' entire treatment course.ConclusionsThe average dose increased by 4 μg/h during the patients' treatment course, which lasted on an average of 260 days. From a clinical perspective, the dose increase of 4 μg/h is low and does not suggest dependence/addiction, as also supported by the low proportion of patients remaining on continuous treatment.Wiley Periodicals, Inc.

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